This course demonstrates a breakthrough in dentistry: extraosseous lesions (EOLs) causing orofacial pain, recalcitrant infection and/or failure to heal after properly done endodontic treatments, extractions, and implants. 2D and 3D microscopy will reveal how endodontic lesions advance outside the bone by a variety of extensions and form EOLs that cannot be seen with current radiography. It will show how EOLs can extend inside the alveolar mucosa as intramucosal lesions, and some can form complex lesions that extend to other dentoalveolar sites and anatomical structures to become multilocular lesions. Multiple cases with long-term follow-up will be presented to show how failing RCTs, implants and extraction sites were resolved when these lesions were completely removed.

The immersive 3D portion presents a variety of complex EOLs involving teeth and implants, and their role in endodontic, periodontal, peri-implant and sinus disease as well as external resorption and aggressive root caries. The use of small-FOV high resolution CBCT will be discussed, along with important new paradigms in diagnosis, treatment planning and treatment. Dental and medical implications will also be presented and related to the various types and locations of the extensions. These cases will clearly demonstrate how accurate diagnosis and treatment predictably result in (1) complete resolution of the infection and its associated symptoms, and (2) the long-term retention of the involved teeth and implants.

This session will help attendees:

• List the three different locations of extraosseous base lesions on teeth.

  • List at least three ways intraosseous lesions become extraosseous.

  • Describe how extraosseous lesions match chronic orofacial pain.

  • Describe how extraosseous lesions cause persistent infection

  • List three common presentations of extraosseous lesions.